U.S. patent number 7,442,202 [Application Number 10/644,779] was granted by the patent office on 2008-10-28 for suture anchor attached to tissue-fixation disk without top knot.
This patent grant is currently assigned to Arthrex, Inc.. Invention is credited to Peter J. Dreyfuss.
United States Patent |
7,442,202 |
Dreyfuss |
October 28, 2008 |
Suture anchor attached to tissue-fixation disk without top knot
Abstract
A suture anchor attached to a tissue-fixation disk with at least
one suture knot which resides in a recess in the suture anchor,
rather than on the exposed surface of the tissue-fixation disk. The
suture that connects the tissue-fixation disk to the suture anchor
is looped through the tissue-fixation disk and through at least one
suture passage formed through the proximal end of the suture
anchor, the free ends of the suture being knotted together within
the suture passage of the suture anchor.
Inventors: |
Dreyfuss; Peter J. (Naples,
FL) |
Assignee: |
Arthrex, Inc. (Naples,
FL)
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Family
ID: |
31891518 |
Appl.
No.: |
10/644,779 |
Filed: |
August 21, 2003 |
Prior Publication Data
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Document
Identifier |
Publication Date |
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US 20040039404 A1 |
Feb 26, 2004 |
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Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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60405706 |
Aug 26, 2002 |
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Current U.S.
Class: |
606/232;
606/300 |
Current CPC
Class: |
A61B
17/0401 (20130101); A61B 2017/0404 (20130101); A61B
2017/0409 (20130101); A61B 2017/0414 (20130101); A61B
2017/044 (20130101); A61B 2017/0458 (20130101); A61B
2017/0459 (20130101); A61B 2017/0496 (20130101) |
Current International
Class: |
A61B
17/04 (20060101) |
Field of
Search: |
;606/53,72,73,232
;24/105,362,115R-115N |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Manahan; Todd E.
Assistant Examiner: Neal; Timothy J
Attorney, Agent or Firm: Dickstein Shapiro LLP
Parent Case Text
This application claims the benefit of U.S. Provisional Application
Ser. No. 60/405,706, filed Aug. 26, 2002, the entire disclosure of
which is incorporated by reference herein.
Claims
What is claimed as new and desired to be protected by Letters
Patent of the United States is:
1. A suture anchor assembly for attachment of tissue to bone, the
suture anchor assembly comprising: a suture anchor comprising a
body member having a distal end, a proximal end, a longitudinal
axis, an outer surface and two transverse suture passages extending
through the body member, the suture passages being substantially
perpendicular to the longitudinal axis, each of the suture passages
having a respective suture recess provided therein; a
tissue-fixation device attached to the suture anchor, the
tissue-fixation device having a plurality of holes; and a single
suture strand that passes through the two transverse suture
passages of the suture anchor and through the holes of the
tissue-fixation device, the single suture strand attaching the
suture anchor to the tissue-fixation device and terminating in at
least one knot disposed within one of the suture recesses of the
suture anchor.
2. The suture anchor assembly of claim 1 further comprising a
plurality of suture grooves in the surface of the body member, such
that a suture groove intersects each opening for the suture
passage.
3. The suture anchor assembly of claim 1, wherein the
tissue-fixation device is in the shape of a disk.
4. The suture anchor assembly of claim 1, wherein the body member
comprises a plurality of thread flights extending from the outer
surface of the body member.
5. A suture anchor assembly for attachment of tissue to bone, the
suture anchor assembly comprising: a suture anchor comprising a
body member having a distal end, a proximal end, a longitudinal
axis, an outer surface, a socket having a shape for receiving a
suture anchor driver, and at least two transverse suture passages
extending through the body member, the two suture passages being
substantially perpendicular to the longitudinal axis, each of the
suture passages being provided with a suture recess, wherein the
suture recess is configured to house a suture knot; a
tissue-fixation device attached to the suture anchor, the
tissue-fixation device being provided with a central aperture
having a shape similar to the shape of the socket for receiving the
suture anchor driver, the tissue-fixation device having a plurality
of holes; and a single suture strand that passes through the two
transverse suture passages of the suture anchor and through the
holes of the tissue-fixation device, the single suture strand
attaching the suture anchor to the tissue-fixation device and
terminating in at least one knot disposed within one of the suture
recesses of the suture anchor.
6. The suture anchor assembly of claim 5 further comprising a
plurality of suture grooves in the surface of the body member, such
that a suture groove intersects each opening for the suture
passage.
7. The suture anchor assembly of claim 5, wherein the suture strand
is looped slidingly through the suture passages.
8. The suture anchor assembly of claim 5, wherein the
tissue-fixation device is in the shape of a disk.
9. The suture anchor assembly of claim 5, wherein the body member
comprises a plurality of thread flights extending from the outer
surface of the body member.
10. A method of attaching tissue to bone using a suture anchor
assembly including a suture anchor having a body member, a distal
end, a proximal end, a longitudinal axis, an outer surface and two
transverse suture passages extending through the body member, the
suture passages being substantially perpendicular to the
longitudinal axis, each of the suture passages having a respective
suture recess provided therein; a tissue-fixation device attached
to the suture anchor, the tissue fixation device having a plurality
of holes; and a single suture strand that passes through the two
transverse suture passages of the suture anchor and through the
holes of the tissue-fixation device, the single strand attaching
the suture anchor to the tissue-fixation device and terminating in
at least one knot disposed within one of the suture recesses of the
suture anchor, the method comprising the steps of: inserting the
suture anchor assembly through the tissue; coupling the suture
anchor assembly to a driver; applying tension to hold the suture
anchor assembly to the driver; and installing the suture anchor
assembly into bone, using the driver, to approximate the tissue to
the bone.
11. The method of claim 10, wherein the suture anchor assembly
further comprises at least one traction line extending proximally
from the tissue-fixation device, the method comprising the further
step of holding the suture anchor assembly onto the driver using
the traction line.
12. The suture anchor assembly of claim 1 wherein the single suture
strand passes continuously through the holes of the tissue-fixation
device and back through the suture passages of the suture anchor,
without terminating at the tissue-fixation device.
13. The suture anchor assembly of claim 12 wherein the single
suture strand passes continuously through four holes of the
tissue-fixation device and back through two suture passages in the
suture anchor, forming two suture loops through the tissue-fixation
device.
14. The suture anchor assembly of claim 12 wherein the single
suture strand passes continuously through four holes of the
tissue-fixation device and back through two suture passages in the
suture anchor, forming four suture loops through the
tissue-fixation device.
15. The suture anchor assembly of claim 5 wherein the single suture
strand passes continuously through the holes of the tissue-fixation
device and back through the suture passages of the suture anchor,
without terminating at the tissue-fixation device.
16. The suture anchor assembly of claim 15 wherein the single
suture strand passes continuously through four holes of the
tissue-fixation device and back through two suture passages in the
suture anchor, forming two suture loops through the tissue-fixation
device.
17. The suture anchor assembly of claim 15 wherein the single
suture strand passes continuously through four holes of the
tissue-fixation device and back through two suture passages in the
suture anchor, forming four suture loops through the
tissue-fixation device.
Description
FIELD OF THE INVENTION
The present invention relates to suture anchors used for attachment
of suture to bone, and more particularly, to a suture anchor
equipped with a tissue fixation device but without a top knot.
BACKGROUND OF THE INVENTION
When soft tissue tears away from bone, reattachment becomes
necessary. Various devices, including sutures alone, screws,
staples, wedges, and plugs have been used to secure soft tissue to
bone. Recently, various types of suture anchors have been developed
for this purpose. For example, U.S. Pat. No. 4,632,100 discloses a
cylindrical suture anchor which includes a drill bit at a leading
end for boring a hole in a bone. The drill bit at the leading end
is followed by a flight of threads for securing the anchor into the
hole bored in the bone by the drill bit. Another example is U.S.
Pat. No. 5,370,662 which discloses a self-tapping suture anchor
having a flight of threads around a solid body. Similarly, U.S.
Pat. No. 5,156,616 discloses a suture anchor having an axial
opening for holding a knotted piece of suture.
The devices disclosed in the above-cited patents anchor suture to
bone, but require the surgeon to tie a knot in the suture
arthroscopically in order to achieve fixation of the soft tissue to
the bone. As a result, devices which do not require arthroscopic
knot tying for fixation have been proposed. For example, U.S. Pat.
No. 6,027,523, the disclosure of which is incorporated by reference
herein, describes a suture anchor equipped with a tissue-fixation
disk which does not require arthroscopic knot tying for fixation.
The free ends of suture of the suture anchor are secured to the
tissue-fixation disk by using knots on the top of the
tissue-fixation disk, as well as a drop of polyacrylamide or
similar cement material to secure the knots to the tissue-fixation
disk.
It would be desirable to provide a suture anchor with an attached
tissue-fixation disk which does not require multiple suture knots
that are exposed on the upper surface of the tissue-fixation
disk.
SUMMARY OF THE INVENTION
The suture anchor of the present invention overcomes the
disadvantages of the prior art and fulfills the needs noted above
by providing a suture anchor attached to a tissue-fixation disk
with a suture knot that resides in a recess in the suture anchor,
rather than on the exposed surface of the tissue-fixation disk.
In the preferred embodiment of the present invention, the suture
that connects the tissue-fixation disk to the suture anchor is a
single strand which is looped through an eyelet or passage formed
through the proximal end of the suture anchor and through the
tissue-fixation disk. Advantageously, the free ends of the suture
are tied in a knot within the eyelet of the suture anchor.
Other features and advantages of the present invention will become
apparent from the following description of the invention which
refers to the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 illustrates a perspective diagrammatic view of a suture
anchor in accordance with a first embodiment of the present
invention.
FIG. 2 illustrates a three-dimensional view of the suture anchor of
FIG. 1.
FIG. 3 illustrates a three-dimensional view of a suture anchor in
accordance with a second embodiment of the present invention.
FIG. 4 illustrates a schematic perspective view of the suture
anchor of FIG. 1 loaded on a driver of the present invention.
FIG. 5 illustrates a schematic elevation of the suture anchor of
FIG. 1 which has been installed according to the present
invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present invention provides a suture anchor attached to a
tissue-fixation disk with a suture knot that resides in a recess in
the suture anchor, rather than on the exposed surface of the
tissue-fixation disk. In the following preferred embodiment of the
invention, the suture that connects the tissue-fixation disk to the
suture anchor is a single strand which is looped through an eyelet
formed through the proximal end of the suture anchor and through
the tissue-fixation disk. Advantageously, the free ends of the
suture are tied in a knot within the eyelet formed through the
proximal end of the suture anchor.
Referring now to the drawings, where like elements are designated
by like reference numerals, FIGS. 1-3 illustrate exemplary
embodiments of suture anchors 100, 200 manufactured according to
the present invention. As explained in more detail below, the
suture anchor of the present invention does not require knots on
the upper surface of the tissue-fixation disk.
The suture anchor 100 of FIGS. 1-2 comprises an elongated body
member 10 and a driving end or head 50 which is associated with a
tissue-fixation device 70. As shown in FIG. 1, the tissue-fixation
device 70 is a disk. However, the invention also contemplates a
tissue-fixation device of other geometric shapes and
configurations, for example, a rod, a straight bar or a bended bar,
among others. The elongated body member 10 has the shape of a
tapered cylinder with a continuous thread 20 wrapping around the
tapered cylinder in a clockwise direction. The elongated body
member 10 is illustrated as having a particular configuration and
geometry, that is, a corkscrew configuration such as the one
disclosed and described in detail in U.S. Pat. No. 6,214,031 to
Schmieding et al., the disclosure of which is incorporated by
reference herein.
Extending from the proximal end of the elongated body member 10 of
the suture anchor 100 is the driving end 50. As illustrated in FIG.
1, for example, the driving end 50 has a distal end 51 and a
proximal end 53. The driving end 50 is provided with two transverse
suture passages 80, 81, preferably both substantially perpendicular
to longitudinal axis 11 of the elongated body member 10. The first
transverse mounting suture passage 80 is seen in FIG. 1 to extend
through the distal end 51 of the driving end 50 and to have opposed
openings 80a, 80b. The second transverse mounting suture passage 81
is located proximal to the first suture passage 80, and is also
provided with two opposed openings 81a, 81b. The second transverse
mounting suture passage 81 is also preferably substantially
perpendicular to the longitudinal axis 11 of the elongated body
member 10, but may also be angulated if desired.
As also shown in FIG. 1, four grooves 82 are provided on either
side of the driving end 50 and extend proximally from each of the
openings of the transverse suture passages 80, 81. Grooves 82
accept and protect suture filament 60 as it passes along the sides
of the driving end 50 of the suture anchor 100. As also illustrated
in FIG. 1, cruciform drive socket 57 is formed in the proximal end
53 of the driving end 50. Preferably, the cruciform drive socket 57
is tapered inward distally and is provided to a depth that allows
sufficient strength while not intersecting with suture passages 80,
81.
As further illustrated in FIG. 1, disk 70 is provided with
cruciform driver opening 77 located centrally on the disk 70 and
aligns with cruciform drive socket 57 of the driving end 50. Disk
70 is also provided with a pair of holes 76 through which a single
suture strand 60 passes for capturing disk 70. As shown in FIG. 2,
the ends of suture strand 60 are tied in a single knot 88 and the
knot 88 is housed into a recess within one of the transverse suture
passages 80, 81, rather than on top surface 73 of the disk 70.
Alternatively, the ends of the suture strand 60 can terminate in
the anchor separately, without being tied together in a single
knot. In this latter embodiment, two separate knots are formed and
housed within two separate suture passages or, alternatively,
within a single suture passage.
FIG. 3 illustrates another embodiment of the present invention, in
which a single suture strand 260 passes around the exterior of the
disk 270 and through the holes 276. As in the previously-described
embodiment, the filament 260 is tied in a single knot which is
secured within eyelet 280 of the suture anchor 200, rather than on
the upper surface of disk 270.
The suture anchor of the present invention may be typically
employed in arthroscopic surgical procedures to repair a rotator
cuff, for example, but may be also used in open surgical
procedures. The suture anchor of the present invention has the
advantage that it eliminates knotting on the upper surface of the
tissue-fixation device improving the efficiency of attachment of
soft tissue to bone in a surgical procedure.
For example, FIG. 4 illustrates the suture anchor assembly 100
(FIGS. 1-2) according to the first embodiment of the present
invention loaded on a driver 90 of the present invention, while
FIG. 5 illustrates the suture anchor assembly 100 (FIGS. 1-2)
installed in the body at a repair site so as to approximate soft
tissue to bone. As shown in FIG. 4, driver 90 of the present
invention has a cannulated handle 92 coupled to a cannulated driver
shaft 94. The distal tip 95 of the driver 90 is shaped to matingly
engage and complement both the cruciform drive socket 57 of the
suture anchor 100 and the central opening 77 formed in the disk 70.
Accordingly, driver 90 rotationally engages both the suture anchor
100 and the disk 70, such that the disk and the suture anchor turn
simultaneously with the driver, avoiding tension on suture strand
60. Accordingly, no twisting or abrading of the suture strand 60
which captures the disk 70 occurs during insertion of the fixation
device into bone.
As also shown in FIG. 4, cannulated driver 90 is provided with
openings near the distal end which accept traction line 36.
Traction line 36 is looped through holes 33 formed in disk 70, as
illustrated in FIG. 4, and is passed through the cannulated driver
90. Tension on traction line 36 applied proximally holds the
fixation device to the driver tip, the traction suture having been
retained in notches 38 formed on proximal end of cannulated handle
92. Traction line 36 can also be used to confirm fixation strength
after installation. Additionally, traction line 36 can be used to
retrieve the disk 70 or the entire fixation device in the event of
device failure during installation. Once the installation and
fixation strength are determined to be adequate, traction line 36
easily is removed by pulling on one end of the traction line.
The driver 90 (FIG. 4) with the engaged suture anchor 100 of the
present invention may be employed for installing the suture anchor
in the body during an arthroscopic surgical procedure, such as
rotator cuff repair. For example, FIG. 5 illustrates the suture
anchor assembly 100 (FIGS. 1-2) installed in the body at a repair
site so as to approximate soft tissue to bone, and after the
removal of the driver 90 from the repair site. As illustrated
diagrammatically in side elevation in FIG. 5, the suture anchor
assembly 100 includes disk 70 which is provided with pair of holes
76 through which the single suture strand 60 passes for capturing
disk 70. As shown in FIG. 5, the ends of suture strand 60 are tied
in single knot 88 and the knot 88 is housed within one of the two
suture passages 80, 81, rather than on top surface 73 of the disk
70.
The elongated body member 10 of the anchor 100, 200 of the present
invention may be constructed from a conventional implantable
biocompatible materials, such as titanium. The disk 70, 270 and
suture strand 60, 260 may be manufactured from conventional
biocompatible polymeric materials and may be absorbable or
non-absorbable. A high strength suture sold by Arthrex, Inc., the
assignee of the present application, under the tradename FiberWire
and described in allowed U.S. Ser. No. 09/950,598, the disclosure
of which is hereby incorporated herein by reference, may also be
employed in the present invention.
Although the present invention has been described above with
reference to a suture anchor having four grooves on the sides of
the driving end, such as the suture anchor 100, 200 having four
grooves 82 on the sides of the driving end 50, it must be
understood that this embodiment is only illustrative and the
invention is not limited to it. Accordingly, the present invention
also contemplates a suture anchor having any plurality of grooves
on the sides of the driving end, as long as the ends of the suture
strand are tied in a knot which is housed within a recess of the
driving end, and not on top of the tissue-fixation disk.
In addition, although the present invention has been described
above with reference to a tissue-fixation device in the form of a
disk, such as the tissue-fixation disk 70, 270, the invention also
contemplates alternative embodiments accomplished with various
types of tissue fixation means substituted for disk 70, 270, such
as a ring, cross, straight bar, or bended bar, among others. In
addition, various types of suture anchors, for example a smooth
spike, barbed spike, cylindrical threaded anchor, or expanding
anchor, can be used to anchor the assembly of the present
invention.
The above description and drawings illustrate preferred embodiments
which achieve the objects, features and advantages of the present
invention. It is not intended that the present invention be limited
to the illustrated embodiments. Any modification of the present
invention which comes within the spirit and scope of the following
claims should be considered part of the present invention.
* * * * *